Colorectal cancer

Norway is one of the countries in the world with the highest incidence of colorectal cancer, but the survival rate for colorectal cancer patients is increasing. 4912 people in Norway got colorectal cancer in 2023.

Last updated: 1/14/2025

Colorectal cancer is the second most common form of cancer in Norway when looking at both sexes together. However, the incidence and mortality of colon cancer in Norway is among the highest in the world, and remains a serious health problem.

The most important treatment is surgery, but a large proportion of patients also receive chemotherapy and/or radiotherapy.

New cases

1665 men and 1723 women contracted colon cancer in Norway in 2023. The number of cases per 100,000 is 56.8 for men and 52.1 for women.

For rectal cancer, there were 1524 cases in total in 2023, and a somewhat higher number among men than among women. The number of cases per 100,000 person-years was 30.3 for men and 19.2 for women.

The risk of colon cancer is roughly the same in women and men, while the risk of rectal cancer is 70 percent higher in men. Before the age of 80, 6% of women and 7% of men will be affected by colon and rectal cancer.

Age distribution

The median age for men and women is for colorectal cancer 74 and 70 years, respectively.

Bowel cancer is very rare in children and young people. During 70 years of registration of cancer in Norway, 145 cases have been registered in the age group 0–19 years. In the very youngest, almost all cases occur in the colon. The disease also occurs rarely among young adults. In recent years, however, an increased incidence has been observed among young adults (20–49 years) in New Zealand, Australia (Araghi et al., 2019) and Europe, including Norway (Vuik et al, 2019).

Sex and age - colon cancer. From figure 2.3 in the Annual Report for the Norwegian Colorectal Cancer Registry 2023 (Norwegian only).

Gender and age - rectal cancer. From Figure 2.24 in the Annual Report for the Norwegian Colorectal Cancer Registry 2023 (Norwegian only).

Survival

The proportion who survive their cancer diagnosis for 5 years or more (5-year relative survival) has increased steadily, and is now around 70 per cent for both colon and rectal cancer. With localized disease, almost all (>95%) patients will survive their cancer for 5 years or more. The corresponding figure for patients with locally advanced spread is over 80%, while the 5-year relative survival for patients with distant spread is around 20%.

Survival estimates can, like incidence, be affected by changes in diagnostic precision and method, and the extent of screening. In order to understand development in the cancer picture over time, it will therefore be helpful to see trends for incidence, mortality and survival together as shown under the section Development over time.

The figures below show age-specific survival for colon and rectal cancer for men and women combined.

The figure shows relative survival for colorectal cancer up to 15 years after diagnosis, distributed by age in the period 2019-2023. From figure 8.2-E in Cancer in Norway 2023.

The figure shows relative survival for rectal cancer up to 15 years after diagnosis, distributed by age in the period 2019-2023. From figure 8.2-F in Cancer in Norway 2023.

While relative survival gives a measure of how many people survive their cancer, conditional 5-year survival gives a measure of the probability of surviving their cancer for five years or more, given that one has already survived a certain number of years.

For colon cancer, women have somewhat higher survival 4–5 years after diagnosis, and five years after diagnosis conditional relative survival is close to 90–95%. This means that the patients will have a 5-10% higher mortality compared to a comparable group without cancer. For rectal cancer, there is little difference in survival between men and women. Conditional 5-year relative survival levels off at around 90% five years after diagnosis.

Relative survival and conditional 5-year relative survival for women and men, colon cancer. From Figure 8.2-E in Cancer in Norway 2023.

Relative survival and conditional 5-year relative survival for women and men, rectal cancer. From figure 8.2-F in Cancer in Norway 2023.

Read more about survival in Spesialutgaven om kreftoverlevelse i Norge 1965–2021

Survivors with colorectal cancer

The number of people who have or have had colon cancer and who are alive has increased significantly and in 2023 the number was 27 108.

The number of people who have or have had rectal cancer has also increased, and was 14 477 in 2023.

Number of deaths

769 men and 735 women died of colorectal cancer in 2022.

Development over time

The incidence of colon and rectal cancer has been increasing for many decades, but the rate of rectal cancer leveled off in the 1990s and is now declining, particularly for men. The incidence rates for colon cancer leveled off around 2010, and there is a slight decrease in the rates for men.

It is an increasing survival rate for both colon and rectal cancer in both sexes.

As regards the development of mortality, there has been a clear reduction for rectal cancer, and mortality is now reduced to half of what it was 30 years ago. This is mainly due to improved treatment, including the introduction of the surgical technique of total mesorectal excision in 1993, increased specialization and more preoperative radiation in the early 2000s. For colon cancer, mortality rates have been more stable, but a slight decline is seen, especially among men, in the last 10–15 years.

However, the incidence and mortality of colon cancer in Norway is among the highest in the world, and remains a serious health problem.

See Cancer Today for bowel cancer incidence and mortality in women and men compared to other countries.

Colon cancer

Trends in incidence, mortality and 5-year relative survival of colon cancer in the period 1965–2022. From Figure 9.1-E in Cancer in Norway 2023.

Rectal cancer

Trends in incidence, mortality and 5-year relative survival of rectal cancer in the period 1965–2022. From Figure 9.1-F in Cancer in Norway 2023.

Norwegian Colorectal Cancer Registry

The Norwegian Colorectal Cancer Registry has existed since 2007. The Rectal Cancer Registry (a separate registry for rectal cancer starting in 1993) was expanded to include colon cancer. The Cancer Registry of Norway is responsible for data processing.

These types of cancer are serious, and the quality registry was established as a contribution to improving diagnostics and treatment for this patient group. The Norwegian Colorectal Cancer Registry aims to strengthen health care for patients with colorectal cancer. The registry shall assess whether the national guidelines for colorectal cancer are being complied with, and it shall map how resources are used and contribute to improvements in treatment results.

The collection of patient-reported outcome measures (PROMs) as a key measure of the quality of the health service will raise the quality and level of the Colorectal Cancer Registry. This is important for patients to be able to say something about their perceived health condition, but also for quality improvement, research and development.

Find annual reports from the Norwegian Colorectal Cancer Registry (Norwegian only).

Who may have a higher risk of colorectal cancer

As for most other forms of cancer, the risk of colorectal cancer increases strongly with age, and the disease rarely manifests itself in young people. In the age group 20-39 years, 6-7 cases per 100,000 person-years are diagnosed, while in comparison, more than 370 cases per 100,000 person-years are diagnosed among women aged 70 and over, and close to 450 cases per 100,000 person-years among men in the same age group.

Age is therefore the strongest risk factor of all. In addition, we know that people who suffer from inflammatory bowel disease such as ulcerative colitis and Crohn's disease have an increased risk of colorectal cancer.

When it comes to hereditary and genetic factors, it is estimated that congenital gene defects are behind less than 5 per cent ofcolorectal cancer cases, while around 20 per cent of cases can be linked to familial colorectal cancer where the underlying gene defect is not known.

Steps you can take to reduce your risk of colorectal cancer

Obesity is a risk factor for colorectal cancer
Read about overweight and weight reduction at helsenorge.no
Risk of colorectal cancer increases with consumption of alcohol
Read about alcohol and cancer on kreftforeningen.no
Regular physical activity reduces the risk of colorectal cancer
Read about physical activity on kreftforeningen.no
The risk of colorectal cancer is reduced by a well-balanced diet
Read about how to prevent cancer through a varied diet at kreftforeningen.no
Bowel cancer can be prevented by detecting precancerous lesions at an early stage
A pilot project for bowel screening is currently underway in Østfold, Akershus and Buskerud. A national programme will be established from 2019 - read more here

In addition to these factors, there is some evidence that there may also be other dietary and nutritional factors that may have an impact on the risk. You can find more about this in the overview from WCRF - Colorectal cancer.

Screening can reduce the incidence of colorectal cancer

Many cases of colorectal cancer develop via precancerous lesions via polyps in the intestine. By finding and removing the most serious precancerous conditions, one can reduce the risk of serious cancer developing.

In 2022, Norway started screening for colorectal cancer. The aim of the screening is to look for cancer and precursors to cancer, so that it can be treated at an early stage and reduce the risk that serious cancer may develop. Screening with colonoscopy for the prevention of colon and rectal cancer has been established in the USA and several European countries. 

The national screening program for bowel cancer has now been rolled out to healthcare facilities across the country.